American Board of Internal Medicine (ABIM) Certification Practice Exam

What therapy should all patients with stages 1 through 5 chronic kidney disease not on dialysis receive, regardless of their cholesterol levels?

1. Beta-blocker therapy

2. Antihypertensive therapy

3. Statin therapy

4. Diuretic therapy

The correct answer is: Statin therapy

For patients with stages 1 through 5 chronic kidney disease (CKD) who are not on dialysis, statin therapy is recommended regardless of their cholesterol levels. Statins are cholesterol-lowering medications that have been shown to have cardiovascular benefits, which is critically important for individuals with CKD. Patients with CKD are at an increased risk for cardiovascular events, and statins can help reduce this risk through their lipid-lowering effects and their ability to stabilize plaques in the arteries. The use of statins in this population is supported by evidence from guidelines indicating that the benefits of statin therapy, including reduced incidence of heart attacks and strokes, outweigh any potential risks. In contrast, while beta-blockers, antihypertensive therapy, and diuretics may be important in managing specific conditions associated with CKD—such as hypertension or fluid overload—they are not universally indicated for all patients with CKD stages 1-5 independent of their individual health profiles and specific clinical indicators. Statin therapy stands out as a necessity for overall cardiovascular risk reduction in this patient population.